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child health > paediatric malnutritionn > Flashcards

paediatric malnutritionn Flashcards

1
Q

how is an underweight child defined ?

A

weight for age < -2 SD

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2
Q

how is a stunting child defined ?

A

height for age < -2 SD

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3
Q

how is wasting inn a child defined ?

A

weight for height < -2SD

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4
Q

how is an overweight child defined ?

A

weight for height > +2 SD

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5
Q

what is stunting ?

A

long term nutritional deprivation and results in :
delayed mental development
poor school performance
reduced intellectual capacity

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6
Q

what are the different types of protein energy malnutrition ?

A

severe PEM :
Marasmus
kwashiorkor

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7
Q

how can acute severe malnutrition be diagnosed ?

A

the presence of one or more of :
mid-upper arm circumference < 115 mm
severe wasting ( < -3SD)
oedema of both feet

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8
Q

what are the features of marasmus ?

A

caused by deprivation of energy + protein
weight loss of more than 20%
maintain their hunger despite appearing irritable

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9
Q

what are the physical findings found upon examination of a marasmus patient ?

A 
loss os subcutaneous fat 
wrinkled skin and bone prominence 
limbs appear as skin and bone
severe muscle wasting 
severe growth retardation
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10
Q

when does marasmus mainly occur ?

A

in infants under one year of age

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11
Q

when does kwashiorkor mainly occur ?

A

at the time of weaning

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12
Q

what is the pathophysiology behind kwashiorkor ?

A

previously malnourished patient when exposed to the catabolic stress of infection

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13
Q

what are the clinical manifestations of kwashiorkor ?

A 
generalized oedema 
skin rash - hyperkeratosis  and desquamation 
distended abdomen and enlarged liver 
angular stomatitis 
flag sign
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14
Q

why may the weight of a kwashiorkor patient not be severely reduced ?

A

because of the severe oedema

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15
Q

what are the lab findings in kwashiorkor ?

A

everything is reduced except sodium

has dilutional hyponatraemia

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16
Q

what are the two phases included in the management of PEM ?

A

stabilisation and rehabilitation

17
Q

when should iron be introduced in the management of PEM ?

A

in the rehabilitation phase only

18
Q

what is the prophylactic dose of iron to avoid iron deficiency anemia ?

A

2mg/kg/day

19
Q

what is the treatment dose of iron in iron deficiency anemia ?

A

6mg/kg/day for 3 months

20
Q

what is the most common cause of microcytic hypochromic anemia ?

A

iron deficiency anemia

21
Q

what additional supplementations can be added to children suffering from iron deficiency anemia and refuse to eat haem sources of iron ?

A

include vitamin c to increase absorption of iron

22
Q

what is pica ?

A

eating things that are not considered food , and may be associated with iron deficiency anemia

23
Q

what is the clinical presentation of vitamin D deficiency ?

A

bony deformity

symptoms of hypocalcemia : seizures, tetany, apnea, stridor

24
Q

what is the difference between rickets and osteomalacia ?

A

rickets :failure in mineralization of the growing bone

osteomalacia : failure of mature bone to mineralize

25
Q

what are the organs involved with calcium absorption ?

A

the intestines and the kidneys

26
Q

what are the different types of rickets ?

A

vitamin D deficiency - Renal disease

calcium deficiency - chronic liver disease

27
Q

what is the most likely cause of rickets that is due to both vit d and calcium deficiency ?

A

malabsorption i.e cystic fibrosis

28
Q

what are the physical features associated with rickets ?

A 
delayed closure of sutures 
bowing of the legs 
frontal bossing 
dental hypoplasia 
pigeon chest 
harrisons sulcus
29
Q

how is a diagnosis of rickets made and how is it confirmed ?

A 
mainly clinical but confirmed by testing :
ALP 
phosphatase 
vit D serum levels 
serum calcium 
long bone X-ray
30
Q

what is the prophylactic dose of vitamin d ?

A

400-600 IU/day

31
Q

what is the treatment dose of vit d ?

A

less than a month : 1000 units
from 1-6 months : 3000 units
above 6 months: 6000 units
all for the duration of one month

32
Q

what is the dose for calcium supplementation ?

A

500 mg/day

33
Q

what is the commonest cause of blindness in children of developing countries ?

A

vitamin A deficiency

34
Q

what are the clinical signs of vitamin A deficiency ?

A 
xeropthalmia 
night blindness 
bitot spots 
dry skin and hair 
broken fingernails
35
Q

what is the dose of supplementation of vitamin A at 12 months ?

A

with MMR vaccine 100.000 IU

36
Q

what is the dose of vitamin A given at 18 months ?

A

with the OPV, DPT and MMR

a dose of 200.000 IU

37
Q 
what is the treatment dose for vitamin A deficiency ?
under 3 years 
4-8 years 
9-13 years 
14-18 years 
all adults
A 
under 3 years - 600 mcg 
4-8 years - 900 mcg 
9-13 years - 1700 mcg 
14-18 years - 2800 mcg 
all adults - 3000 mcg

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